An Unexpected Adverse Event during Colonoscopy Screening: Bochdalek Hernia

Joon Seop Lee; Eun Soo Kim; Min Kyu Jung; Sung Kook Kim; Sun Jin; Deok Heon Lee; Jun Won Seo

doi:10.4166/kjg.2018.71.5.290

Journal List > Korean J Gastroenterol > v.71(5) > 1094741

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Lee, Kim, Jung, Kim, Jin, Lee, and Seo: An Unexpected Adverse Event during Colonoscopy Screening: Bochdalek Hernia

Case Report

Korean J Gastroenterol 2018;71(5):290-293.

Published online: 4 October 2018

DOI: https://doi.org/10.4166/kjg.2018.71.5.290

An Unexpected Adverse Event during Colonoscopy Screening: Bochdalek Hernia

Joon Seop Lee^1,², Eun Soo Kim^1,², Min Kyu Jung^1,², Sung Kook Kim^1,², Sun Jin^1,², Deok Heon Lee^3,⁴, Jun Won Seo⁵

¹Division of Gastroenterology, Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Korea

²Division of Gastroenterology, Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea

³Department of Thoracic and Cardiovascular Surgery, School of Medicine, Kyungpook National University, Daegu, Korea

⁴Department of Thoracic and Cardiovascular Surgery, Kyungpook National University Hospital, Daegu, Korea

⁵Medical Institute, Daegu, Korea

Correspondence to: Eun Soo Kim, Division of Gastroenterology, Department of Internal Medicine, School of Medicine, Kyungpook National University, 130 Dongdeok-ro, Jung-gu, Daegu 41944, Korea. Tel: +82-53-200-5512, Fax: +82-53-426-2046, E-mail: dandy813@hanmail.net

Received 29 January 2018 Revised 12 March 2018 Accepted 28 March 2018

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Bochdalek hernia (BH) is defined as herniated abdominal contents appearing throughout the posterolateral segment of the diaphragm. It is usually observed during the prenatal or newborn period. Here, we report a case of an adult patient with herniated omentum and colon due to BH that was discovered during a colonoscopy. A 41-year-old woman was referred to our hospital with severe left chest and abdominal pain that began during a colonoscopy. Her chest radiography showed colonic shadow filling in the lower half of the left thoracic cavity. A computed tomography scan revealed an approximately 6-cm-sized left posterolateral diaphragmatic defect and a herniated omentum in the colon. The patient underwent thoracoscopic surgery, during which, the diaphragmatic defect was closed and herniated omentum was repaired. The patient was discharged without further complications. To the best of our knowledge, this case is the first report of BH in an adult found during a routine colonoscopy screening.

Keywords: Hernia, diaphragmatic, Colonoscopy, Screening

References

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Fig. 1.

Colonoscopic view showing a narrowed and twisted lumen at the splenic flexure.

Fig. 2.

(A) Chest radiography after colonoscopy showing colonic air shadow protruding into the left thoracic cavity. (B) Chest radiography before colonoscopy with normal results.

Fig. 3.

Computed tomography scan showing a 6-cm-sized left posterolateral diaphragmatic defect and herniated omentum in the colon (arrow).

Fig. 4.

Thoracoscopic view of the diaphragm. A diaphragmatic defect with herniated omentum in the colon in the thoracic cavity is observed.

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